The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

As support for clinical ethics committees in the UK grows, care must be taken to define their function, membership and method of working and the status of their decisions.The modern practice of medicine raises a plethora of complex issues—medical, ethical and legal. Doctors and other healthcare professionals increasingly must try to resolve these and may sometimes have to do so in the face of contrary opinion expressed by patients and/or their surrogates. While clearly qualified in the medical arena, and although (...) there is now more ethics teaching in the medical curriculum, healthcare professionals are seldom qualified to adjudicate on ethical or legal matters, or even, perhaps, to recognise them when they arise. Yet, as Doyal says, “clinical life must go on and moral and legal indeterminacy within medicine cries out for practical resolution.”1 Meanwhile, the expectations of patients and their families—and, indeed, of wider society—are that decisions about patient care, resources and therapeutic regimes should be soundly based on appropriate ethicolegal, as well as scientific, principle.Recognition of these additional burdens on healthcare professionals has generated some interest in the provision of ethics consultation. In the USA this has been undertaken by a variety of tribunals and individuals. Hospital ethics committees and ethics consultants feature in many US hospitals and perform a variety of roles. In Europe, a number of countries have also established clinical ethics committees and they are becoming more common in the UK—primarily in England and Wales for the moment. Whereas, however, “[i]n North America, CECs have … become an integral part of the organisational infrastructure of hospitals ...”,1 in the United Kingdom they remain essentially ad hoc bodies, generated for a variety of reasons and with different goals, structures, membership, methods of working and functions. The initial impetus for the …. (shrink)

The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

The patient-doctor relationship has recently come under intense scrutiny, resulting in a re-evaluation of the basis of that relationship. The papers by Glannon and Ross, and McKay seek to identify the sources of authority in the patient-doctor relationship by evaluating it in terms of the concept of altruism. In this paper I argue that the analysis of Glannon and Ross, and of McKay is unnecessary and that the analysis offered by the latter is also flawed. I do acknowledge, however, that (...) Glannon and Ross's description of doctors' responsibilities and patients' roles has much to commend it. (shrink)

A medical profession which did not seek improved means to conquer disease would be condemned for dereliction of its duty, Members of the public will not accept the current state of the medical arts as finite but feel justified in expecting the development of more effective therapies for illness, and the promotion of improved means of preventive care.With this assertion, the distinguished academic, Bernard Dickens, places research firmly in the domain of the public interest. Foster agrees, saying that, “[t]o improve (...) medical care as much as we can, if not to perfect it, means that we have to accept the need for research.” Giesen adds a further emphasis to the search for medical advancements, saying that “freedom of research and scientific inquiry is, in itself, an important aspect of open societies.“. (shrink)

A medical profession which did not seek improved means to conquer disease would be condemned for dereliction of its duty, Members of the public will not accept the current state of the medical arts as finite but feel justified in expecting the development of more effective therapies for illness, and the promotion of improved means of preventive care.With this assertion, the distinguished academic, Bernard Dickens, places research firmly in the domain of the public interest. Foster agrees, saying that, “[t]o improve (...) medical care as much as we can, if not to perfect it, means that we have to accept the need for research.” Giesen adds a further emphasis to the search for medical advancements, saying that “freedom of research and scientific inquiry is, in itself, an important aspect of open societies.“. (shrink)

The so-called genetics revolution rests on a history which at its least can be described as controversial. Modern genetics needs to bear this history in mind. In particular, as with the past, the area of reproductive choice seems particularly vulnerable to potential abuse. Courts in the UK and elsewhere have already shown themselves willing to interfere with the choices of women in the management of their pregnancies. Medical advance, perhaps particularly the capacity to visualise the developing foetus, has added complexity (...) to the question of whether the health care provider has one patient or two patients . Additionally, pregnancy is thoroughly monitored in modern medical practice and genetics may provide a further impetus or incentive to mandate increased policing of pregnancy. Gene therapy, once offered, will add further to the desire to ensure that women make the ‘right’ choice, especially when the invasion required is relatively minimal. Further, genetic information is at best predictive, but may, because of its scientific nature, appear to those receiving it to be certain. Thus, the provision of genetic information may reduce rather than enhance choice, unless carefully and sensitively provided. A mature and sophisticated debate about the role of genetics in reproduction is required—engaging rather than bypassing the public—if the real potential of genetics is to be vindicated. (shrink)

The system of clinical ethics committees (CECs) in the United Kingdom is based on goodwill. No formal requirements exist as to constitution, membership, range of expertise or the status of their recommendations. Healthcare professionals are not obliged to use CECs where they exist, nor to follow any advice received. In addition, the make-up of CECs suggests that ethics itself may be under-represented. In most cases, there is one member with a training in ethics – the rest are healthcare professionals or (...) administrators, although a lawyer is generally also included in the membership. This begs the question as whether CECs can ‘do ethics’, as well whether or not they can take seriously the requirements of due process, formal justice and human rights. Moreover, the role of the patient in this system is opaque. (shrink)

Understanding the causes of maize landrace loss in farmers’ field is essential to design effective conservation strategies. These strategies are necessary to ensure that genetic resources are available in the future. Previous studies have shown that this loss is caused by multiple factors. In this longitudinal study, we used a collection of 93 maize landrace accessions from Morelos, Mexico, and stored at the International Maize and Wheat Improvement Center Maize Germplasm Bank, to trace back to the original 66 donor families (...) after 50 years and explore the causes for why they abandoned or conserved their seed lots. We used an actor-centered approach, based on interviews and focus group discussions. We adopt a Multi-Level Perspective framework to examine loss as a process, accommodating multiple causes and the interactions among them. We found that the importance of maize landrace cultivation had diminished over the last 50 years in the study area. By 2017, 13 families had conserved a total of 14 seed lots directly descended from the 1967 collection. Focus group participants identified 60 accessions that could still be found in the surrounding municipalities. Our findings showed that multiple interconnected changes in maize cultivation technologies, as well as in maize markets, other crop markets, agricultural and land policies, cultural preferences, urbanization and climate change, have created an unfavorable environment for the conservation of maize landraces. Many of these processes were location- and landrace-specific, and often led to landrace abandonment during the shift from one farmer generation to the next. (shrink)

The suspension of major sporting competitions due to the global COVID-19 pandemic had a substantial negative impact on the sporting industry. As such, a successful and sustainable return to sport will require extensive modifications to the current operations of sporting organizations. In this article we argue that methods from the realm of sociotechnical systems theory are highly suited for this purpose. The aim of the study was to use such methods to develop a model of an Australian Football League club’s (...) football department. The intention was to identify potential modifications to the club’s operations to support a return to competition following the COVID-19 crisis. Subject Matter Experts from an AFL club participated in three online workshops to develop Work Domain Analysis and Social Organization and Cooperation Analysis models. The results demonstrated the inherent complexity of an AFL football department via numerous interacting values, functions and processes influencing the goals of the system. Conflicts within the system were captured via the modeling and included pursing goals that may not fully reflect the state of the system, a lack of formal assessment of core values, overlapping functions and objects, and an overemphasis on specialized roles. The current analysis has highlighted potential areas for modification in the football department, and sports performance departments in general. (shrink)

ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...) experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form.Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. (shrink)

Understanding the causes of maize landrace loss in farmers’ field is essential to design effective conservation strategies. These strategies are necessary to ensure that genetic resources are available in the future. Previous studies have shown that this loss is caused by multiple factors. In this longitudinal study, we used a collection of 93 maize landrace accessions from Morelos, Mexico, and stored at the International Maize and Wheat Improvement Center (CIMMYT) Maize Germplasm Bank, to trace back to the original 66 donor (...) families after 50 years and explore the causes for why they abandoned or conserved their seed lots. We used an actor-centered approach, based on interviews and focus group discussions. We adopt a Multi-Level Perspective framework to examine loss as a process, accommodating multiple causes and the interactions among them. We found that the importance of maize landrace cultivation had diminished over the last 50 years in the study area. By 2017, 13 families had conserved a total of 14 seed lots directly descended from the 1967 collection. Focus group participants identified 60 accessions that could still be found in the surrounding municipalities. Our findings showed that multiple interconnected changes in maize cultivation technologies, as well as in maize markets, other crop markets, agricultural and land policies, cultural preferences, urbanization and climate change, have created an unfavorable environment for the conservation of maize landraces. Many of these processes were location- and landrace-specific, and often led to landrace abandonment during the shift from one farmer generation to the next. (shrink)

Males are often found to outperform females in tests of mathematics achievement and it has been proposed that this may in part be explained by differences in cognitive style. This study investigated the relation between Wholistic-Analytic and Verbal-Imagery cognitive style, gender and mathematics achievement in a sample of 190 Australian primary school students aged between 8?11?years (M?=?9.77, SD?=?1.05). It was hypothesised that males would outperform females in mathematics achievement tests, and that gender would interact with cognitive style on mathematics performance. (...) A significant gender/cognitive style interaction was found. Boys with an Analytic/Imagery style achieved significantly higher results than the girls with an Analytic/Imagery style, supporting the contention that certain cognitive styles affect boys and girls mathematics performance differently. Implications of results and strategies for improving mathematics achievement among girls are discussed. (shrink)

The starting point of my analysis is the complexity of contemporary society. Complexity here refers more in particular to social complexity: the type of complexity that emerges from the relationships between human beings and the myriad of options and possibilities that exist in our society. A systems theoretical account of complexity elicits that this 'social abundance' necessitates selections. One way of enabling selections, and hence the reduction of complexity, is the formulation of norms. The central thesis of this account follows (...) from this observation: social complexity is a source of normativity, in the sense that social complexity generates – among others – normativity. Dealing with social complexity requires selections and a considerable range of selections, at their turn, require norms. From a somewhat different angle, we could say that social complexity entails both freedom of choice and force of choice. It is this combination of freedom and force that confronts our society with a profound problem. It translates, so to speak, social complexity into uncertainty: how to deal with all these options and possibilities, how to shape our interactions? An important aspect of the problem is the abundance of colliding heteronymous norms and a simultaneous lack of ethical norms that do not compromise our individual autonomy. The analysis of this ethical state of affairs draws upon the work of Zygmunt Bauman. The paper tentatively seeks to outline the social theoretical requirements of an ethic that takes issue with the uncertainty of choice. (shrink)

Many think doing animal ethics demands we see moral humanism as a speciesist prejudice of the kind found with sexism and racism. The only serious case for this rests on the Argument from Marginal Cases. We find that argument to the point, but show that properly understood it supports humanism. Understanding why it does this lets us see how we ought to go on in animal ethics.

Das Grab des Königs Ninetjer in Saqqara: Architektonische Entwicklung frühzeitlicher Grabanlagen in Ägypten. By Claudia M. Lacher-Raschdorff. Deutsches Archäologisches Institut Kairo, Archäologische Veröffentlichungen, vol. 125. Wiesbaden: Harrassowitz Verlag, 2014. Pp. 295, 44 pls., plans. €247.

This text explores how human beings construe experience: experience as a resource, as a potential for understanding, representing and acting on reality.